STUDY QUESTIONS AND ANSWERS FOR NR566

STUDY QUESTIONS AND ANSWERS FOR NR566 Anti-Androgens - CORRECT ANSWER-Finasteride (Propecia) Leuprolide (Eligard, Lupron, Lupron Depot) Spironolactone (Aldactone) Finasteride (Propecia, Proscar) - CORRECT ANSWER-blocks conversion of testosterone to dihydrotesterone Used to tx: -BPH -male pattern baldness 3 months of therapy need to see benefits Stopping, reverses effect w/in 12 months Adverse side effects: - Decreased libido -Impotence dutasteride (Avodart) - CORRECT ANSWER-5-alpha reductase inhibitor used to tx: BPH Can stay in serum up to 6 mon after discontinuing can be absorbed through skin pregnant woman shouldn't handle capsules (fetal anomaly in male fetus) Adverse Effects decreased libido Impotence Leuprolide Acetate (Lupron) - CORRECT ANSWER-Luteinizing hormone - releasing agonist create reversible: -orchiectomy state -oophorectomy state Used to tx: - advanced prostatic cancer - Management of endometriosis - Uterine fibroids - polycystic ovarian disease - central precocious puberty in peds Flutamide (Eulexin, Euflex) - CORRECT ANSWER-Truly non-steroidal agent Used to tx: -Advanced prostate cancer -female androgen excess syndrome Adverse Effects in males - gynecomastia -reversible liver toxicity Black Box Warning -hepatic failure -hepatic encephalopathy Basline/monthly liver function test for 1st 4 months Spironolactone (Aldactone) - CORRECT ANSWER-aldosterone antagonist potassium sparing diuretic used for tx: -female hirsutism (abnormal growth of hair) -acne -relief of PMS/PMDD symptoms (25-50 mg/d) Adverse reactions - dose related + reversible when discont. -GI upset -Drowsiness -Gynecomastia -Impotence -Cutaneous (skin) eruptions - Urticaria Black Box Warning Tumorigenicity in animals Should not be used during pregnancy Androgen - CORRECT ANSWER-Testosterone most important adrogen in humans levels remain stable at 55yr 70 yrs men decrease in -strength, libido, muscle mass Transdermal application of testosterone - CORRECT ANSWER-Patch + gel can be applied to intact nonscrotal skin once daily not for use in woman men cannot have skin contact with pregnant woman or children Men need to wash hands after application + allow skin to dry Testopel - CORRECT ANSWER-Subcu Pellet produces testosterone for 3-6 months Contraindications for Testosterone - CORRECT ANSWER-Male breast cancer prostate cancer Pregnancy (X category) Lactation Complications of Testosterone - CORRECT ANSWER-- Edema w/or w/out congestive heart failure (use caution in pts w/ preexisting cardiac, renal, or hepatic disease) Increased risk for -prostatic hypertrophy -prostatic hyperplasia -prostatic carcinoma Hypogonadal men might experience sleep apnea This risk increases in men w/obesity or chronic lung disease. Refer to endocrinologist - CORRECT ANSWER-stimulating growth in boys with delayed puberty aging men to increase strength + muscle mass Adverse Reactions Androgens - CORRECT ANSWER-Prolonged high dose use = -life threatening hepatitis -hepatic neoplasms -Hepatocellular carcinoma Methyltestosterone + fluoxymesterone low dose: -cholestatic hepatitis -Jaundice All Patients -Nausea -vomiting -change in liver function - edema - Cholestatic jaundice -Suppression of clotting factors - Increased red blood cell production (Hemorrhage + Thrombus) Gender Specific side effects of testosterone - CORRECT ANSWER-Gynecomastia Reduced sperm levels Ance Baldness Decrease libido Depression Headache Scrotal pain Goin pain Changes in Urination Priapism (A sustained erection) Women: Menstrual irregularities Hypercalcemia Virilization Anabolic Steroids - CORRECT ANSWER-Peliosis (blood cysts in liver) liver tumors Testosterone Drug Interactions - CORRECT ANSWER-Diabetic agents Anticoagulants Corticosteroids Imipramine Cyclosporine Clinical use Androgens - CORRECT ANSWER-Hormone replacement for hypogonadal males or male climacteric (late onset hypogonadalism or testosterone deficiency syndrome) Endometriosis Refractory anemia Estrogen for osteoporosis + loss of libido Estrogen - CORRECT ANSWER-Endogenous Hormone maturation + function of the female reproductive system Effects of Estrogen on the reproductive Cycle - CORRECT ANSWER--Maturation of reproductive organs -Development of secondary sexual characteristics -Regulation of the menstrual cycle -Endometrial regenerations postmenstration - Closure of long bones after puberty growth spurt